Japan has one of the best healthcare systems in the world — but it works very differently from what most English-speaking families are used to. This page explains how it works, what insurance covers, and how to communicate effectively at a clinic.
Section 1
Japan's system is universal, high-quality, and affordable — but it follows a specific process. Here is what to expect from the moment you walk in to the moment you leave.
On your first visit, bring your health insurance card. Staff will ask: "Do you have a health insurance card? Have you been here before?" You will fill out a registration form. On return visits, present your patient card.
First visit — bring health insurance card and IDIf you are unsure which department to visit, describe your symptoms to a nurse or staff member and they will direct you. You can also use our Symptom to Specialist guide in Navigating Care.
Before seeing the doctor, a medical staff member will ask about your symptoms and medical history in detail. If you cannot write Japanese, bring a printed multilingual questionnaire from the MMQ website.
Average consultation time in Japan is around 5 minutesThe doctor will explain test results and discuss treatment options. Tests are done if necessary. Many hospitals in Japan see patients on a first-come, first-served basis — appointment holders go first.
After your consultation, bring your file to the cashier. At large hospitals you take a number and wait until it appears on the board, then pay at the window or automated machine. Numbers on your receipt are points — 1 point = 10 yen under public insurance.
If prescribed medication, pick it up at a dispensing pharmacy (調剤薬局 — chozai yakkyoku) outside the hospital. Your prescription is valid for four days and can only be used once.
Pharmacy is outside the hospital — look for 調剤薬局If ongoing treatment is required, schedule your next appointment before leaving. You can also request a referral letter (紹介状) if you need to see a specialist or larger hospital.
Hospitals with 200+ beds charge extra without a referral letter (5,000–10,000 yen)Key things to know
Patients pay 30% of medical costs — public insurance covers the remaining 70%
A standard clinic visit costs roughly ¥1,000–3,000 with insurance
You can visit any clinic or hospital — there are no provider networks or restrictions
Dental, basic maternity, vision, and specialist care are all covered under the same public insurance
Giving birth, cosmetic surgery, and orthodontics are not covered — full cost applies
Japan has a catastrophic cost cap of approx. ¥57,600–80,100/month even for major treatment
Useful vocabulary at reception
Section 2
Foreign residents staying in Japan for more than three months are required by law to enroll in public health insurance. Here is what you need to know.
Most common for residents
For residents not covered by employer insurance. Managed by local ward offices. To enroll, bring your residence card to the National Health Insurance counter at your ward office within 14 days of arriving. Premiums are income-based — as low as ¥2,000/month for new arrivals in the first year.
If employed in Japan
For full-time workers at medium to large companies. Your employer handles enrollment. Dependents — including spouses and children — can be covered under the same plan. Covers the same services as NHI at the same 70/30 split.
Supplemental
You can buy supplemental private insurance in Japan or abroad. Most expats use it alongside public insurance for coverage gaps. For travel insurance, pay the full cost at the hospital upfront and submit a claim to your insurer. Always ask if they need an English medical certificate — hospitals may charge extra to produce one.
If you are uninsured you still have access to programs for child vaccinations, tuberculosis treatment, medical care for disabled children, and maternity support. Ask at your local ward office or the clinic you visit.
Enrollment steps for NHI
1
Arrive in Japan
Register your address at the ward office within 14 days
2
Go to ward office
Bring residence card and My Number Card
3
Enroll in NHI
Go to the National Health Insurance / Pension counter
4
Receive your card
Carry it to every clinic visit — required at reception
Section 3
Use these at the clinic to communicate with staff, point to symptoms, or understand what you are being given. Each entry shows English, Japanese, and romanization.
| English | Japanese | Romanization |
|---|---|---|
| Good morning | おはようございます | Ohayo gozaimasu |
| Good afternoon | こんにちは | Konnichiwa |
| Good evening | こんばんは | Kombanwa |
| Thank you | ありがとうございます | Arigato gozaimasu |
| I don't understand | わかりません | Wakarimasen |
| I understand | わかりました | Wakarimashita |
| Please speak more slowly | もっとゆっくり話してください | Motto yukkuri hanashite kudasai |
| Please repeat that | もう一度言ってください | Moichido itte kudasai |
| What does this mean? | これはどういう意味ですか？ | Kore wa doiu imi desu ka? |
| I can't speak Japanese | 日本語を話せません | Nihongo o hanasemasen |
| I feel unwell | 体の調子が悪いです | Karada no choshi ga warui desu |
| Please take me to the hospital | 病院に連れて行ってください | Byoin ni tsurete itte kudasai |
| Please call an ambulance | 救急車をよんでください | Kyukyusha o yonde kudasai |
| My symptoms are here | 症状がある部分はここです | Shojo ga aru bubun wa koko desu |
| Is a female doctor available? | 女の先生はいますか？ | Onna no sensei wa imasu ka? |
| Is a male doctor available? | 男の先生はいますか？ | Otoko no sensei wa imasu ka? |
Point to where it hurts and say: 症状がある部分はここです (Shojo ga aru bubun wa koko desu) — "My symptoms are here."
| English | Japanese | Romanization |
|---|---|---|
| Where is the reception? | 受付はどこですか？ | Uketsuke wa doko desu ka? |
| I have an appointment | 予約があります | Yoyaku ga arimasu |
| I would like to cancel my appointment | 予約をキャンセルしたいです | Yoyaku o kyanseru shitai desu |
| How long do I have to wait? | どのくらいの時間待ちますか？ | Donokurai no jikan machimasu ka? |
| When should I come back? | 次はいつ病院に来たらいいですか？ | Tsugi wa itsu byoin ni kitara ii desu ka? |
| How much does treatment cost? | 治るまでにいくらかかりますか？ | Naoru made ni ikura kakarimasu ka? |
| Do you accept credit cards? | クレジットカードは使えますか？ | Kurejitto kado wa tsukaemasu ka? |
| I forgot my insurance card | 保険証を忘れました | Hokensho o wasure mashita |
| Please write a certificate in English (for insurance) | 保険会社に出す英語の診断書を書いてください | Hokengaisha ni dasu eigo no shindansho o kaite kudasai |
| Where is the pharmacy? | 薬局はどこですか？ | Yakkyoku wa doko desu ka? |
| Consultation room | 診察室 | Shinsatsu shitsu |
| Blood collection room | 採血室 | Saiketsu shitsu |
| Examination room | 検査室 | Kensa shitsu |
| Inpatient ward | 病棟 | Byoto |
| Restroom | トイレ | Toire |
Note: Japan commonly dispenses powdered medicine (粉薬). If it is difficult to swallow, ask for Oblaat — a thin edible starch wrap. Japanese cold medicine typically combines fever reducers, antihistamines, and cough suppressants in one packet.
| When to take it | Japanese | Romanization |
|---|---|---|
| In the morning | 朝 | asa |
| In the afternoon | 昼 | hiru |
| In the evening | 夜 | yoru |
| After meals | 食後 | shoku go |
| Before meals | 食前 | shoku zen |
| Between meals | 食間 | shokkan |
| Before bed | 寝る前 | neru mae |
| As needed (when symptoms appear) | 頓服 | tompuku |
Section 4
A reference for what each medical department handles in Japan, including the Japanese name you will see on signs and registration forms.
| Specialty | Japanese | What they treat | When to go |
|---|---|---|---|
| Internal Medicine | 内科 (naika) | General illness, fever, cold, flu, chronic conditions (diabetes, hypertension), fatigue | Start here if unsure which department you need |
| Surgery | 外科 (geka) | Wounds, injuries, operations, tumors requiring surgical intervention | Lacerations, injuries needing stitches, surgical consults |
| Pediatrics | 小児科 (shonika) | All childhood illness, vaccinations, growth and development | Any health concern for children under ~15 |
| Cardiology | 循環器科 (junkanki ka) | Heart disease, chest pain, irregular heartbeat, high blood pressure | Chest pain, palpitations, shortness of breath at rest |
| Pulmonology | 呼吸器科 (kokyuki ka) | Lung conditions, asthma, chronic cough, breathing difficulties | Persistent cough, wheezing, asthma management |
| Gastroenterology | 消化器科 (shokaki ka) | Digestive system — stomach, intestines, liver, gallbladder, colon | Stomach pain, reflux, diarrhea, constipation, bloody stool |
| Orthopedics | 整形外科 (seikeigeka) | Bones, joints, muscles, ligaments, spine | Back pain, fractures, sports injuries, joint pain |
| Urology | 泌尿器科 (hinyoki ka) | Urinary tract, kidneys, bladder, male reproductive health | Painful urination, kidney stones, blood in urine |
| Dermatology | 皮膚科 (hifu ka) | Skin, hair, nails — rashes, eczema, acne, moles, infections | Rashes, persistent itching, skin growths, hair loss |
| ENT | 耳鼻咽喉科 (jibiinko ka) | Ear, nose, throat — hearing, sinuses, tonsils, voice | Ear pain, chronic sinus issues, hearing loss, sore throat |
| Ophthalmology | 眼科 (ganka) | Eyes — vision problems, infections, dry eye, glaucoma | Eye pain, blurry vision, discharge, foreign object in eye |
| Gynecology / Obstetrics | 産婦人科 (sanfujin ka) | Women's reproductive health, pregnancy, menstrual issues, mammograms | Period issues, pregnancy care, pelvic pain, breast concerns |
| Psychiatry | 精神科 (seishin ka) | Mental health — depression, anxiety, sleep disorders, psychosis | Persistent low mood, anxiety, insomnia, emotional distress |
| Dentistry | 歯科 (shika) | Teeth, gums, jaw — cavities, extractions, cleaning, crowns | Toothache, gum issues, routine dental check-ups |
Section 5
If you are coming from the United States or another Western country, Japan's healthcare system will feel noticeably different. Understanding these differences upfront makes navigating it much easier.
Japan's system is built on free access — patients can walk into almost any clinic or hospital without first being assigned to a primary doctor. Unlike the U.S., there is no formal GP gatekeeper system. This gives you more flexibility, but also means you are responsible for deciding where to go and what kind of care you need.
Side by side comparison
| Category | U.S. / Western System | Japan's System |
|---|---|---|
| First point of contact | Usually your registered primary care doctor (GP or family doctor) | Any clinic the patient chooses — no registration required |
| Access to specialists | Usually requires a referral from your primary doctor first | Patients can often visit specialists directly without a referral |
| Choosing where to go | Guided by your primary doctor or insurance network | Patient decides independently based on their own judgment |
| Role of the doctor | Coordinates long-term care, referrals, and continuity | Often focused on the specialty area of that specific clinic |
| Continuity of care | Usually centralized through one physician | Often spread across multiple clinics depending on concern |
| Hospital access | Usually structured through referral pathways | Direct access possible, but large hospitals charge extra without a referral letter (紹介状) |
| Patient responsibility | Lower — the system largely guides next steps for you | Higher — patients must navigate options and make their own decisions |
| Wait times | Varies widely; specialist waits can be weeks to months | Local clinics: 15–30 min. Large hospitals: often several hours |
Why clinics feel different
Many neighborhood clinic doctors in Japan originally trained as hospital specialists before opening private practices. A local internal medicine clinic may be run by a doctor whose original training was in cardiology or gastroenterology. Japan does not have a strict legal GP qualification system, so each clinic's strengths depend on the doctor's background — which adds flexibility but can make choosing the right clinic less obvious.
The referral letter (紹介状)
If you visit a large hospital (200+ beds) for the first time without a referral letter from a smaller clinic, you will be charged an additional fee — typically ¥7,000 or more. This is intentional policy to reduce overcrowding at major hospitals and encourage routine care at local clinics first. Getting a referral letter from a neighborhood clinic before visiting a large hospital will waive this fee.
Wait times by facility type
Local Clinics
15–30 min
Most local clinics now use digital booking systems via their website or LINE app — you can check in remotely, track live queue updates, and arrive only when your turn is near.
Large / University Hospitals
1–4+ hours
Major hospitals handle complex cases and specialist treatment, but because anyone can walk in, they are often crowded. Expect long waits. A referral letter from a local clinic will prioritize your appointment and waive the extra fee.
What this means for you
The biggest adjustment for international residents is recognising that you are expected to make more decisions yourself — choosing where to go, knowing which clinic fits your concern, and understanding when a referral is needed. The system is not broken; it just works differently.
Once you understand how it works, Japan's healthcare is actually highly accessible and often faster than Western systems for routine concerns. The challenge is not the quality of care — it is learning to navigate the system with confidence. That is exactly what this guide is for.
Section 6
These bilingual forms are used by clinics and hospitals across Japan. Print the one that matches your appointment, fill it in before you go, and hand it to the receptionist — it removes the language barrier before you even see the doctor.
Each form below opens the official PDF. Print it, fill it in at home, and bring it to your appointment. All forms are bilingual — English on the left, Japanese on the right. The Japanese version takes priority in case of any translation discrepancy.
General & Internal Medicine
Use this form when visiting a general clinic for symptoms like fever, cough, fatigue, nausea, weight loss, or any concern that doesn't fit a specific specialty. Covers current symptoms, medication history, and past conditions.
Print and fill in before your appointment. Bring it alongside your insurance card.
Use this form for respiratory concerns including cough, wheezing, shortness of breath, chest pain, or phlegm. Includes phlegm characteristics and symptom patterns.
Specialist Forms
For chest pain, palpitations, shortness of breath, irregular pulse, dizziness, or swelling. Includes a body diagram to mark where pain occurs and detailed pain type options.
For nausea, vomiting, diarrhea, constipation, heartburn, bloody stool, appetite loss, or weight loss. Includes detailed stool characteristics and body diagram.
For rashes, hives, eczema, itching, dry skin, moles, burns, insect bites, athlete's foot, or any skin concern. Includes a body diagram to mark affected areas.
For children's clinic visits. Covers fever, rash, vomiting, ear pain, and developmental concerns. Includes vaccination history, feeding method, birth conditions, and current spreading illnesses at school or nursery.
For anxiety, depression, insomnia, low energy, concentration difficulties, or other mental health concerns. Includes current symptom trend and work, school, or family stressors.
For injuries, lumps, swelling, hemorrhoids, or any concern requiring surgical evaluation. Includes stool details and a full body symptom diagram.
For varicose veins, cold hands and feet, leg cramps when walking (intermittent claudication), or other circulation concerns.
For frequent urination, difficulty urinating, blood in urine, pain when urinating, or urinary incontinence. Also covers sexual health concerns.
For headaches, dizziness, numbness, paralysis, vision disturbance, difficulty speaking, or stroke-related concerns. Distinguishes between ongoing symptoms and temporary episodes.
For joint pain, sprains, injuries, stiff shoulders, numbness, dislocation, or difficulty moving limbs. Includes body diagram to mark affected area and severity scale.
For blurry vision, eye pain, redness, discharge, floaters, double vision, dry eyes, or foreign object in the eye. Specifies which eye is affected.
For ear pain, hearing loss, ringing, dizziness, nosebleed, nasal congestion, sore throat, difficulty swallowing, or hoarse voice. Covers all three areas in one form.
For pregnancy check-ups, menstrual concerns, vaginal discharge, abnormal bleeding, or fertility consultations. Includes full menstrual history and pregnancy history sections.
For toothache, gum pain, loose teeth, bleeding gums, lost fillings, jaw pain, or dental alignment concerns. Also includes past reactions to anesthesia or treatment.